Personality Trait Stability in Borderline Personality Disorder
This paper critically reviews Hopwood et al.'s (2009) longitudinal study on personality trait stability in individuals diagnosed with borderline personality disorder (BPD). The study tracked 130 BPD patients and 302 controls with other personality disorders over six years, using multiple personality assessments. The review summarizes key findings — that structural stability was comparable across groups, but differential and ipsative stability were lower in BPD patients, especially in neuroticism and conscientiousness — and evaluates the study's methodology, clinical implications, and limitations. The paper also situates the findings within the broader, contested diagnostic history of BPD.
- Introduction: BPD and the Problem of Personality Stability: Historical and conceptual context for BPD diagnosis
- Overview of the Hopwood et al. Study: Study design, participants, and central hypothesis
- Key Findings on Trait Stability: Differential and ipsative stability lower in BPD group
- Clinical Implications of the Results: How trait instability should inform BPD treatment
- Methodological Critique: Tautology risk and limits of self-report measures
- Conclusion: What the Study Adds to BPD Literature: Study confirms instability but raises diagnostic questions
✍️ How to write this paper — guide, tools & examples ▾
What makes this paper effective
- The paper moves fluidly from summarizing the source article to offering a pointed critique, demonstrating the student's ability to both report and evaluate research.
- It contextualizes the study within the broader diagnostic history of BPD, grounding technical findings in a wider clinical narrative.
- The critique of potential tautology in the methodology is sophisticated, showing engagement with epistemological questions about diagnostic validity.
Key academic technique demonstrated
The paper models the critical article review format effectively. Rather than merely summarizing Hopwood et al., the author evaluates the study's methodology (noting the circular logic risk in accepting existing diagnoses), weighs its clinical usefulness, and positions the findings against prior literature, including the DSM criteria and Oldham (2005). This layered approach — summary, analysis, critique — is the hallmark of a strong graduate-level review.
Structure breakdown
The paper opens with conceptual and historical context for BPD as a diagnosis, then introduces the study and its hypothesis. It proceeds through study design, findings, and clinical implications, before raising methodological concerns and concluding with a frank assessment of the study's contribution to the existing literature. This funnel-and-return structure keeps the argument coherent and grounded throughout.
Introduction: BPD and the Problem of Personality Stability
Personality disorders have a problematic diagnostic history in psychiatric literature. The idea of defining someone's "character" has challenged philosophers and research psychologists throughout the ages. Behind the characteristics defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) as Axis II personality disorders (PDs) lies an assumption of a certain level of character stability in individuals classified as having schizoid personality disorder or obsessive-compulsive personality disorder. One of the most controversial disorders defined by the DSM is borderline personality disorder (BPD), commonly characterized by an abnormal instability of personality traits and behaviors, rather than a state of abnormal stability.
Often, individuals with a diagnosis of BPD seem to defy characterization: occasionally they appear to embody the textbook criteria for the illness, and at other times they wildly deviate from it. They may show the characteristic idealization followed by reviling of significant others, then shift into socially avoidant behavior after feeling hurt and seeing their expectations for others go unmet. This pattern is profoundly different from that seen in consistently socially avoidant personality types, or in histrionic personality types who persistently seek out others to dramatize their real and imagined complaints.
To re-evaluate the diagnostic criteria for borderline personality disorder and its impact upon "several domains" of functioning "including interpersonal behavior, affect, and identity" seemed essential, according to Hopwood et al. (2009), in order to clarify the nature of this disorder. Hopwood and colleagues embarked upon a study published in the journal Abnormal Psychology entitled "The Stability of Personality Traits in Individuals with Borderline Personality Disorder." The central hypothesis of the study was that apparent inconsistencies in the personality traits of BPD patients are not an indication of a problematic or inaccurate definition of the disorder, but rather are part of the illness itself (Hopwood et al., 2009, p. 806).
Overview of the Hopwood et al. Study
To test the major thesis of the study, the authors classified five types of personality trait stability using four types of assessments. One hundred and thirty BPD patients completed the assessments over a course of six years and were compared with a control group of 302 patients with other types of personality disorders. This longitudinal design allowed the researchers to track how personality trait profiles shifted — or remained stable — over an extended period within both groups.
Key Findings on Trait Stability
The findings of the study indicated that basic, structural personality stability did not differ significantly between the two groups over the six years of the study. However, differential stability tended to be lower in BPD patients, most notably in the five-factor model (FFM) characteristics of neuroticism and conscientiousness, with less deviation observed in extraversion, openness, and agreeableness. The BPD group was also less stable in self-reported (ipsative) profiles than other personality-disordered individuals (Hopwood et al., 2009, p. 806).
In particular, neuroticism and conscientiousness "showed greater mean-level change, with neuroticism declining faster and conscientiousness increasing faster, in the BPD group" as compared with other traits in the FFM (Hopwood et al., 2009, p. 806).
Clinical Implications of the Results
The results of the study suggest that personality trait instability is characteristic of BPD, and that clinicians should anticipate and expect such variation over the course of treatment as an inherent part of the disorder. BPD patients may occasionally show apparent remission or normalcy in traits such as neuroticism, whereas patients with histrionic or depressive personality disorders tend to manifest these traits more consistently.
This finding also has important implications for how clinicians interpret what appears to be therapeutic progress. While a marked reduction in neuroticism might signal genuine responsiveness to treatment in a patient with a depressive personality type, in a BPD patient the same reduction may represent another manifestation of the illness — part of the BPD cycle of fixating on a person or situation to temporarily ease the patient's lack of a stable core identity.
The results thus call for careful, ongoing clinical monitoring and caution against interpreting short-term trait improvements in BPD patients as evidence of sustained recovery. Understanding trait instability as intrinsic to BPD, rather than as noise in the diagnostic picture, may help clinicians better calibrate their treatment expectations and interventions for this population. Resources such as Mayo Clinic's overview of BPD offer a useful reference for the clinical symptom profile against which these findings can be situated.
Conclusion: What the Study Adds to BPD Literature
It is nonetheless questionable how much this study adds to the existing literature on BPD, given that the current DSM criteria for diagnosis already include "instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts" (Oldham, 2005). Instability is already built into the diagnosis itself.
The diversity of BPD characteristics may also be rooted in the uncertain diagnostic history of the disorder. Once considered to lie on the "borderline" between psychosis and neurosis, BPD is now viewed as an impulse disorder that may be exacerbated by trauma — such as childhood sexual abuse — and by dysregulation of serotonin in the central nervous system (Oldham, 2005).
Ultimately, this study appears to confirm primarily that individuals who receive a diagnosis of BPD are more likely to show trait instability, which the authors interpret as a product of the illness itself. Alternatively, these findings could be read as a consequence of clinicians using BPD as a "garbage can" diagnosis for a wide variety of difficult-to-treat anxiety, depressive, and impulse-control disorders. Either interpretation points to the need for greater diagnostic precision and continued longitudinal research into the nature of personality stability in this population.
References
Hopwood, C. J., et al. (2009, November). The stability of personality traits in individuals with borderline personality disorder. Abnormal Psychology, 118(4), 806–815.
Oldham, J. M. (2004, July 1). Borderline personality disorder: An overview. Psychiatric Times. Retrieved July 19, 2010, from
Always verify citation format against your institution’s current style guide requirements.